Wednesday, February 29, 2012

Just So Expectations Are Correct - A Small Delay In PCEHR Enquiry Until March 13, 2012.

The following was posted yesterday here:

Personally Controlled Electronic Health Records Bill 2011 and one related bill

Information about the Inquiry

On 25 November 2011 the Senate jointly referred the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011 and the Personally Controlled Electronic Health Records Bill 2011 for inquiry and report.
Submissions should be received by 12 January 2012. The reporting date is 29 February 2012. On 28 February 2012,the Senate granted an extension of time for reporting until 13 March 2012.
The Committee is seeking written submissions from interested individuals and organisations preferably in electronic form submitted online or sent by email to community.affairs.sen@aph.gov.au as an attached Adobe PDF or MS Word format document. The email must include full postal address and contact details.
Alternatively, written submissions may be sent to:
Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600
Australia
Notes to help you prepare your submission are available from the website at http://www.aph.gov.au/senate/committee/wit_sub/index.htm. Alternatively, the Committee Secretariat will be able to help you with your inquiries and can be contacted on telephone +61 2 6277 3515 or facsimile +61 2 6277 5829 or by email to community.affairs.sen@aph.gov.au.
Inquiries from hearing and speech impaired people should be directed to Parliament House TTY number 02 6277 7799. Adobe also provides tools at http://access.adobe.com/ for the blind and visually impaired to access PDF documents. If you require any special arrangements to enable you to participate in the Committee's inquiry, please contact the Committee Secretariat.
Once the Committee accepts your submission, it becomes a confidential Committee document and is protected by Parliamentary Privilege. You must not release your submission without the Committee's permission. If you do, it will not be protected by Parliamentary Privilege. At some stage during the inquiry, the Committee normally makes submissions public and places them on its website. Please indicate if you want your submission to be kept confidential.
For further information, contact:
Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600
Australia
----- End Page.
Just for information. Hope I am not breaking any laws.
David.

NEHTA Is Now Failing In Its Core Task. They Are Withdrawing Issue Ridden Specifications After Announcing Them As Final Ages Ago!

In December 2010 NEHTA released its final specification for Electronic Transfer of Prescriptions Version 1.1
This specification was to be run through the Standards Australia IT-14 Committee to be endorsed as an Australian Standard.
Essentially this has failed to happen and NEHTA has now (14 months later)  produced a short 5 page update: Here is the key part of the first page:

Release Notification

Status Update

Electronic Transfer of Prescription 1.1

Final
Release Update: 27 February 2012 (Red is as document is presented showing how important it is I guess)
NEHTA published the Electronic Transfer of Prescriptions (ETP) 1.1 Specification Release in December 2010. This specification was progressed as a candidate for the Standards Australia IT-014 Informatics Community process with a view to realising a series of connected, formal Australian Technical Specifications. NEHTA is committed to supporting this standards publication process, and notes that a number of changes to the specification have been collected from relevant industry, policy makers and service providers, and have been applied to the specification.
NEHTA advises interested parties that ETP Release 1.1 will be superseded by an incremented release in mid-2012 and ETP Release 1.1 is now for information purposes only.
This Release Notification Status Update provides a broader communication as to the status of this Specification. Interested parties should contact NEHTA through the contact details at the end of this document should they wish to develop solutions based on ETP specifications.
-----
On page 4 (of 5) we find the following:

Known Issues

NEHTA has identified the following open issues affecting the release:
  • These specifications will be updated based on feedback through Standards Australia and are considered “for information only”. A future release expected in Mid 2012 will incorporate the this feedback.
  • The documents numbered 10 to 13 in the above list are platform-specific technical documents and have not yet been validated through live implementations in commercial clinical systems. For this reason the documents are identified as “Draft for trial implementation”. NEHTA will work with early implementers to offer support and contribute to validation of these technical documents.
  • The release specifies the National Authentication System for Health (NASH) as the mechanism for the provision and management of Public Key Infrastructure (PKI) certificates for mutual authentication and also message encryption and signing. At the time of the release, NASH is still in development, but is scheduled to be available to early implementers.
  • The release does not specify the technical mechanisms for document authors to digitally sign Clinical Document Architecture (CDA) documents. NEHTA is closely monitoring current national and international standards efforts to reach consensus on a CDA signing approach. NEHTA will work with Standards Australia and early implementers to finalise this mechanism.
  • The release does not specify the credentials used by document authors to digitally sign ETP documents. NEHTA continues to work with clinical stakeholders to reach agreement on and obtain Commonwealth, state and territory approvals of the credentials required for the digital signing of ETP documents. It is expected that the approved credentials will be based upon individual Public Key Infrastructure (PKI) certificates managed by the NASH.
  • The release does not specify the technical mechanisms for the submission of electronic prescriptions to Medicare Australia for PBS claim verification and audit, nor the technical mechanism for healthcare recipients to digitally sign for the receipt of PBS medications. NEHTA continues to work with Medicare Australia to specify these mechanisms.

Feedback

NEHTA continues to welcome feedback on the ETP package, which can be emailed to  medication.management@nehta.gov.au as can any questions relating to this package. Priority areas for feedback include errors of omission or commission, and issues that would adversely impact consumer choice and the timely provision of prescription and/or dispensed medication information.

Specification Development and Implementation

With the release of this final package, NEHTA’s ETP-related stakeholder engagement will turn to the development of guidance for the implementation and use of the ETP solution along with compliance, conformance and governance. NEHTA will also be actively seeking implementation partnerships.
The next release of ETP is expected mid-2012 and is being developed in concert with Standards Australia (IT 14-06-04 Working Group).
---- End Extracts
The full document can be found here:
What an amazing farce we have here. NEHTA and DoHA have known for ages that this specification was not fit for use and from other sources I have heard much of the concern and angst in the SA Committees about this and the associated pressure for delivery.
Who knows just why the Version 1.1 was left out there as final for so long. I guess they were busily working behind the scenes to get it fixed and just now realised they should say something. Another theory goes there was a DoHA payment due and NEHTA needed a deliverable. Don't you love conspiracy theories - I have heard this one from a few sources however.
Of course we also do have a HL7 V2 spec which is pretty widely used and which is probably also being updated. It is simpler and probably much more useable.
The MSIA have also known for a while the new NEHTA specs were not fit for use and mentioned that in one of their submissions.
I just hope no one has spent any money trying to implement the new one. Clearly NEHTA needs to utterly revamp the way it goes about the delivery of specifications such as this to ensure this sort of nonsense is not repeated. Essentially this is another 14 months wasted in a major and important application area.
David.

Tuesday, February 28, 2012

The Pot Seems To Have Been Bigger Than We Have Ever Imagined. It Has Mostly Been Spent Apparently With More Needed!

The following appeared today:

Labor's Personally Controlled Electronic Health Record system blows out to $760m

SPENDING on Labor's Personally Controlled Electronic Health Record system has blown out to $760 million, almost $300m more than the $466.7m budget.
The National E-Health Transition Authority has swallowed the original allocation almost whole -- it has received $466m in taxpayers' money since the PCEHR was announced by former health minister Nicola Roxon in 2010.
The $760m price tag to date has been uncovered by The Australian in a detailed analysis of statutory records available from the federal Health Department, AusTender, the Senate Community Affairs committee and the Council of Australian Governments.
COAG allocated $218m in base funding for NEHTA for a three-year period from July 2009 until the PCEHR's promised operational start on July 1 this year.
Half of this funding came from the commonwealth while state and territory governments contributed the other half.
The Health Department gave NEHTA another $136m to develop specifications for the infrastructure and related software and systems, from July 09-12.
The latest departmental records show NEHTA recently received a $21m top-up on funding to $110m, for the provision of services related to the PCEHR's introduction from January last year.
The original $38.5m contract was for six months to the end of June last year, but extended in August to $89m for the period to October 31.
Separately, NEHTA has received $1.5m in grants funding for four related projects.
NEHTA's latest annual report shows $122.4m in revenue during 2010-11, comprising $114m in receipts from jurisdictional members and $1.2m in other income, mainly interest payments.
At the time, NEHTA was holding $10m in revenue received but not yet earned.
A year earlier, NEHTA reported $95.6m in revenue, with $99m from members and other income of about $765,000.
A NEHTA spokeswoman said yesterday the earnings stated in the most recent accounts "represented revenue received by the entire company, not just that pertaining to COAG funding".
"NEHTA's budget for the current year has been set in accordance with funding allocations for the COAG and PCEHR programs," she said.
"There have been no new or additional allocations from COAG."
More here - showing where all the private sector contracts went and the large sums spent there get worked through in some detail:
In an opinion piece from the author we read.

E-health records' $1m a day bill

KEVIN Rudd's plan for a popular, patient-centric e-health record system - announced to general head-scratching in early 2010 - has morphed into a lumbering monster that remains frustratingly out of everyone's grasp.
Allocated a mysteriously precise sum of $466.7m over two years in that budget, it now appears the decision was made by the boss in a hurry, without the benefit of proper cabinet consideration as former health minister Nicola Roxon revealed last week.
Expenditure has now reached $760m, meaning Labor has been spending an incredible $1.04m each and every day since - a sizeable increase on the originally budgeted $639,315 a day for delivery of a personally controlled e-health system.
While Roxon was lashing Rudd over his mishandling of "some very big health decisions", she surely compounded difficulties by insisting on a flat, July 1, 2012, launch date for the PCEHR.
Common sense should have dictated a degree of flexibility around the deadline in such a technically complex IT project.
Unsurprisingly, the e-health arena is in turmoil, and the Senate Community Affairs committee is currently trying to establish what we will actually get when the PCEHR is turned on.
More here:
On the basis that these figures are about right - and lets not quibble about a few million here or there - it is safe to say this is a bit of an overrun - and it is more important to realise that lots more will be needed in just on four months from now.
It seems to me this report makes it crucial for the current PCEHR Senate Enquiry to ask for, from Government, an urgent report that lays out clearly just what has been spent on what and more importantly what the future spending is planned and over what ongoing period.
I personally would also like to see the Auditor General get involved to work through both the numbers and the value for money aspects of what has been delivered to date.
I would also like to see an independent investigation on just what impact this huge expenditure has had on the local Health Software industry and if there have been damaging impacts on what are many really quite small companies - compared with the scale of Government and the major contractors.
I take the view that the public is entitled to be assured that for the money spent they have had value delivered. I fear we won’t see the work done but is really should be before more funds are committed. We need to know our taxes are being well spent. Remember this is an investment of over $30 for every man, woman and child.
I wonder what others think about such expenditure continuing to go un-assessed, un-justified by evidence or business case and apparently un-ending.
Remember there is no chance at all that we will see an operational PCEHR any time soon - and certainly not in 4 months time. A registration portal maybe but not much else. I am sure I could have saved a good few hundred million if all that I had to deliver was a registration portal. 
Also of great concern is the apparently chaotic way the PCEHR was planned and executed. That is another aspect of all this - along with the spending - that should be closely examined.
David.

Monday, February 27, 2012

Weekly Australian Health IT Links – 27th February, 2012.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

By the time this appears we will have the political situation sorted out - for the time being - and we will all still be wondering just why you would take any Australian politician seriously ever again.
Out of all this we have certainly discovered more about the nonsense that has gone on behind health policy - see the first article - in the last few years. The sad thing is that the PCEHR seems to have been one of the ‘thought bubbles’ that came from that unstable period. It will be fascinating to see what the Government decides to do with the PCEHR over time.
I predict it will be months (probably years) before we really know what the real outcome of the recent machinations will be. The effects on e-health will take a while to emerge - so for now we have to just let the ructions pass - and wait.
-----

Rudd wanted referendum on federal health takeover

24th Feb 2012
IN THE last days of his prime ministership Kevin Rudd wanted a referendum on a federal takeover of the health system during the 2010 election, former health minister Nicola Roxon revealed today.
As Mr Rudd arrived back in Australia after spectacularly quitting as foreign minister overseas, verbal attacks between his supporters and those of his successor, Julia Gillard, became increasingly frank ahead of an expected leadership showdown on Monday.
Ms Roxon, promoted to attorney-general under Ms Gillard and now backing the prime minister, said Mr Rudd was told a referendum on a health takeover wouldn't succeed but he nevertheless "thought it would be a good tool to be able to win the election".
-----

Feeling anxious? Soon there will be an app for that

BENEDICT CARE
February 15, 2012
The very idea of psychotherapy seems to defy the instant-access, video screen chatter of popular digital culture.
Not for long, if some scientists have their way. In the past few years researchers have been testing simple video-game-like programs aimed at relieving common problems like anxiety and depression. These recent results have been encouraging enough that investigators are now delivering the programs on smartphones — therapy apps, in effect, that may soon make psychological help accessible anytime, anywhere, whether in the grocery store line, on the bus or just before a work presentation.
The prospect of a therapy icon next to Angry Birds and Fruit Ninja is stirring as much dread as hope in some quarters. "We are built as human beings to figure out our place in the world, to construct a narrative in the context of a relationship that gives meaning to our lives," said Dr. Andrew J. Gerber, a psychiatrist at Columbia University. "I would be wary of treatments that don't allow for that."
-----

Health staff spend $340,000 on travel

INTERNATIONAL travel costs of Health Department employees during 2011-12 totalled more than $340,000.
The costs of trips varied from $1515 for a study trip to Oregon in the US to $48,247 for four staff to travel to the UK and US for the reference check stage of the new statewide electronic Enterprise Patient Administration System.
SA Health chief executive David Swan said the $344,408 spent on overseas travel played an important role for the department.
Note: I think the money spent of system reference checks was a very good thing. The rest others can comment on.
-----

NEHTA: eHealth specifications testing resumes

Posted on February 17, 2012
The National E-Health Transition Authority (NEHTA) has now resumed testing specifications after halting eHealth records trials, said NEHTA CEO Peter Fleming.
Back in January, NEHTA discovered that due to detected technical incompatibilities for specifications pushed to the eHealth trial sites, the implementation of primary care eHealth software has paused.
Hoever NEHTA has now re-commenced testing for the national Accenture platform to support the eHealth records this month, ensuring the system interoperates with other vendors’ software.
-----

The NBN's digital productivity potential

  • Published 9:05 AM, 22 Feb 2012
  • Last update 11:17 AM, 22 Feb 2012
After some five years of public debate on the National Broadband Network (NBN) it is heartening to see that more and more people are getting the message that the network means more than just fast internet access. Increasingly key decision-makers in business and government are reaching an understanding of the transformation that is underway in the economy.
It started with the music industry, followed by the publishing industry. The retail sector is learning its lessons the hard way but it is now beginning to understand the new environment. The entertainment industry is still trying to stop the tsunami by employing armies of lawyers, but it will soon also be engulfed by the changes. The banking sector is making a much smoother transition, while the demise of Kodak is another example of ‘missing the boat’.
One by one, all sectors of the industry are being confronted with the business transformation that the internet is bringing with it, and yet, incredibly, the ICT industry itself is still struggling with it (Sensis, Nokia, Microsoft, Motorola, Nortel, etc).
-----

85% of hospitals embracing BYOD, survey shows

Most employees are restricted to Internet access only
A survey of the networking priorities of 130 hospitals found that about 85% support the use of personal devices like iPads, Blackberries and Android smartphones at work.
The survey, performed by Aruba Networks , focused mainly on network issues and showed varying levels of access to business apps through employees' devices.
Of the 85% who indicated they support physician and staff use of personal devices at work, 53% said that the workers are currently relegated to Internet access only, while 24% provide limited access to hospital applications.
-----

iPads not safe for clinical diagnosis: new research

Apple’s iPad should not be used for making diagnosis in clinical settings, new research from the University of Sydney has warned.
According to Dr Mark McEntee, a senior researcher at Sydney University’s discipline of medical radiation sciences, iPads (and other portable devices) don’t have the screen brightness or resolution to compete with high-end clinical monitors.
“iPads and other secondary screens should not be used for clinical diagnosis,” he told eHealthspace.org. “There is a range of safety concerns associated with using mobile screens.”
-----

Faith lost over e-health record, few GPs see value

21st Feb 2012
JUST 5% of GPs understand how the government’s personally controlled e-health record system (PCEHR) will work and what will be expected of them when it is rolled out on 1 July, while only a quarter think the system will help with consultations.
The apparent lack of faith in the government’s e-health records system was revealed in a survey of 150 GPs, conducted by Cegedim on behalf of MO, which also found 76% of GPs still held concerns over the lack of remuneration on offer to compensate for  time spent by doctors curating the electronic records.
-----

Ratings websites a sore point with doctors

21st Feb 2012
MOST GPs haven’t bothered to look up their names on ‘doctor-rating’ websites but more than half hold concerns such sites could harm their practice or reputation, according to survey results released today.
The Cegedim survey of 150 GPs, conducted on behalf of medical defence organisation Avant, found that while 77% of respondents had not bothered to look for ratings of themselves or any other practitioner, 60% were concerned such ratings could be damaging.
And, although more than half of respondents felt it was “reasonable for a patient to give their doctor a rating on a website out of 10 based on their staff, knowledge, helpfulness and punctuality", Avant CEO David Nathan said patient ratings weren’t always that fair.
-----

Conference tackles health care supply chain

February 21, 2012 
Representatives from nearly 30 countries will converge in Sydney for the 21st GS1 Global Healthcare Conference, 20-22 March 2012.
Held in Australia for the first time, the conference will be hosted by not for profit supply chain standards organisation GS1 Australia.
It aims to raise the bar on patient outcomes through efficient and timely access to medical devices, consumables and pharmaceuticals in the healthcare sector.
-----

Addict prints own prescription

PRESCRIPTION drug addict Matthew John Liddell had used a doctor's computer to print out his own prescription while the doctor was out of the room, Toowoomba Magistrates Court heard yesterday.
Liddell, 26, had lost a leg in a car accident in 2008 and had been prescribed the narcotic pain reliever OxyContin for the ensuing four years, the court heard.
However, he became addicted to the drug and doctors wouldn't prescribe it for him anymore.
-----

Australian sperm donors' details could be linked to birth certificates

20 February 2012
The state parliament in New South Wales (NSW), Australia, is considering whether sperm and egg donors' details should be mandatorily recorded on their children's birth certificate.
Under the current law, only the two legal parents of the child can be recorded on the birth certificate but there are concerns that this limits the child's access to details of their biological parents later in life.
Donor information in the state is at present collected on a central register kept by the Department of Health. The NSW Health Central Register includes mandatory information about donors including their full name and address, ethnicity and medical history. Information is collected for children, born as a result of fertility treatment using donated gametes or embryos, conceived after 1 January 2010. Prior to this date such information could be provided voluntarily.
-----

Allied eHealth

Published on Tue, 21/02/2012, 09:49:06
Allied health professionals need incentive payments to encourage their participation in the Personally Controlled Electronic Health Record (PCEHR) program, according to national peak body, Allied Health Professions Australia (AHPA).
AHPA president Vittorio Cintio has commended the overall objective of the PCEHR legislation, which he said would give consumers more control over their health information and allow healthcare providers quicker and in some cases, shared access to patient records. 
But he wants the government to provide support for allied health professionals to be able to participate in the eHealth system, just like it does for GPs.
-----

Liberal MPs to vote for e-health records

LIBERAL MPs will vote to pass the Gillard government's legislation on personally controlled e-health records in the lower house, but warn they may move changes when the findings of a Senate inquiry are released.
Opposition e-health spokesman Andrew Southcott said the Coalition supported the concept of shared e-health records, but had concerns about the way the system was being implemented.
"Labor's implementation of the PCEHR since taking government in 2007 has received enormous criticism from industry for the poor management of the program's development and progress," he told the house last week.
-----

Big reforms for government technology

  • GARY STERRENBERG, CHIEF INFORMATION OFFICER, DEPARTMENT OF HUMAN SERVICES
GARY Sterrenberg is overseeing one of the biggest government technology reforms ever as head of the 37,000-strong Human Services mega-department.
He is managing the integration of Medicare, Centrelink and child support agencies at infrastructure and customer support levels, and the linking of 20 government agencies in an online portal.
Mr Sterrenberg, the Department of Human Services chief information officer, took charge of the reforms from retiring head John Wadeson in October, three months after its service delivery reform began.
-----

Argus achieves CCA for secure messaging

Written by Kate McDonald on 22 February 2012.
Database Consultants Australia's (DCA) Argus version 6.0 secure messaging product has passed the Conformance, Compliance and Accreditation (CCA) assessment process for the National E-Health Transition Authority's (NEHTA) secure messaging delivery (SMD) implementation.
It was evaluated by two independent assessors in January and received its formal documentation of compliance from KJ Ross & Associates on February 15.
Argus' general manager Ross Davey said the team had been early adopters of the CCA initiative because it believed a common approach to clinical messaging will eventually lead to better capabilities for health professionals.
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GPs to challenge govt on e-health costs

20th Feb 2012
GPs concerned about a major workload increase from managing the federal government's personally controlled electronic health record (PCEHR) are planning to confront the government with the initiative’s true cost to their business before it goes live.
With the PCEHR to launch on 1 July, the AMA’s Council of General Practice agreed at the weekend to commence work that would calculate the likely extra cost to general practices and a new fee schedule to present to the government before then.
“I think the government thinks it’s going to happen by autopilot,” AMA president Dr Steve Hambleton told MO.
-----

Video games bring a see change

February 19, 2012
DOCTORS have treated people born with a rare eye disorder by prescribing a course of gun-toting video games.
Adults who played first-person shooter games for 40 hours a month improved enough to read one or two lines further down a standard chart used in eye tests, the researchers found.
Games that required players to respond to action directly ahead of them and in the periphery of their vision, and to track objects that were sometimes faint and moving in different directions, strengthened the visual system in adults whose eyesight had been severely impaired from birth.
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NHMRC funded research to be free to public

22nd Feb 2012
BEGINNING in July, all publications based on NHMRC-funded research must be placed in the public domain, the CEO Professor Warwick Anderson has announced.
The publications must be placed into an “institutional repository” within 12 months of publication, and will be available free of charge, he said.
Although the NHMRC decided on the proposal internally last year, the mandate was only made public yesterday, in an opinion piece written by Professor Anderson for the website The Conversation, an NHMRC spokesperson said.
-----

Nano-transistor breakthrough to offer billion times faster computer

Deborah Smith
February 20, 2012
SYDNEY scientists have built the world's tiniest transistor by precisely positioning a single phosphorus atom in a silicon crystal.
The nano device is an important step in the development of quantum computers – super-powerful devices that will use the weird quantum properties of atoms to perform calculations billions of times faster than today's computers.
Michelle Simmons, of the University of NSW, said single atom devices had only been made before by chance and their margin of error for placement of the atom was about 10 nanometres, which affected performance.
-----

Scientists try to make sense of nothing

Dennis Overbye
February 22, 2012
Why is there something, rather than nothing at all?
It is, perhaps, the mystery of last resort. Scientists may be at least theoretically able to trace every last galaxy back to a bump in the Big Bang, to complete the entire quantum roll call of particles and forces. But the question of why there was a Big Bang or any quantum particles at all was presumed to lie safely out of scientific bounds, in the realms of philosophy or religion.
Now even that assumption is no longer safe, as exemplified by a new book by the cosmologist Lawrence Krauss. In it he joins a chorus of physicists and cosmologists who have been pushing into sacred ground, proclaiming more and more loudly in the past few years that science can explain how something – namely our star-spangled cosmos – could be born from, if not nothing, something very close to it. God, they argue, is not part of the equation. The book, A Universe From Nothing, is a best-seller and follows recent popular tomes such as God Is Not Great, by the late Christopher Hitchens; The God Delusion, by Richard Dawkins; and The Grand Design, by the British cosmologist Stephen Hawking (with Leonard Mlodinow), which generated headlines two years ago with its assertion that physicists do not need God to account for the universe.
-----
Enjoy!
David.

AusHealthIT Poll Number 110 – Results – 27th February, 2012.

The question was:
Do You Believe NEHTA and DoHA Are Properly Addressing Patient Safety In The PCEHR Program?
They Are Fully Across All Safety Issues
- 1 (2%)
They Are Trying Hard
-  11 (26%)
They Are Just Paying Lip Service To The Issue
-  9 (21%)
They Don't Really Understand The Issue
-  21 (50%)
Votes: 42
Very interesting result - most seem to think patient safety is being treated with less care and seriousness that it deserves.
Again, many thanks to those that voted!
David.

Sunday, February 26, 2012

Very Interesting Material Has Been Revealed About Consumer Registration for a PCEHR. This Dog Will Not Hunt and It Is Delayed Already!

A few days ago there was a presentation from NEHTA on the Consumer Registration Process for a PCEHR.
You can download the presentation here:
22 February 2012 - PCEHR registration process and demonstration of Source Forge
  • Click here to access the recording (22MB)
  • Click here to download the presentation (1.13MB)
The talk covered the so-called Assisted Registration Process.
The talk was by Les Schumer - Design Authority Manager at NEHTA.
There was no discussion of unassisted processes which I assume must also exist.
The aims of the process are to make it quick and simple to register and for it to be able to happen while sitting in the waiting room assisted by receptionist using a B2B process.
Known Customer Approach will be used for identification checking. The criteria will be that the consumer has visited the facility 3 times in past. Any health facility will do apparently (GP Practice, Pharmacy, Hospital, Aged Care Home etc.)
The work flow is intended to be:
1. Consumer reads descriptive brochure which includes terms and conditions - not discussed at talk.
2. Hands brochure to receptionist with a request to register for PCEHR, having signed the brochure saying I want a PCEHR (Here comes paperwork back to Medicare Australia!).
3. The receptionist opens patient record (which has IHI).
Registration screen comes up:
Check Boxes cover 4 areas:
1. Acceptance of the PCEHR Terms and Conditions
2. Receptionist checks box to assert this is a known customer.
3. Receptionist asks does consumer want Medicare Information included in their PCEHR (presumably explained earlier)
4. Asked how would you like you Identity Verification Code (IVC) to be sent:
a. Letter
b. Text
c. Email.
In each case this will be some information already attached to patient’s Medicare file (home address, mobile number etc.).
The registration then fires off - makes the fully set up record can be used by GP and patient when they get their IVC - in the meantime the GP or whoever has created a Health Summary.
Apparently you then log on to Australia.gov.au - using the code you are given to confirm identity - and then set up privacy controls.
It seems any healthcare organisation that wants to can provide the registration service.
Apparently there will be a soft launch of the registration process after July, 1 2012.
But after all this we are told:
NEHTA do not have all the policy settings or specifications as yet however - this is just early warning.
And, right at the end of the presentation Andrew Howard informed the audience that this process would not be ready for July 1, 2012 but some 2-3 months later.
Presumably the registration portal - with a different approach - will be available earlier.
Comments on All This:
1. The amount of time taken from the receptionists day to do all this will be a major issue for the doctors who pay them to do other things!
2. There is still no incentive for GPs etc. to do anything that will muck up work flows in their practice.
3. It is not clear what happens if you move into an area and then want a PCEHR - you have to run up three visits (and the costs) before you can start?
4. How does the system deal with all those who already have a second ID for a particular practice for a particular purpose (e.g. Aids treatment, Mental Health etc.) - it can easily be fake but long standing! We know Medicare has more than one of these!
No wonder the launch will be soft (i.e. slow and unpublicised) - to avoid embarrassment I suspect.
We will await developments.
If you want to see what the consumer and providers are  being told here are the recent links:
Enjoy - they are short and colourful!
David.

Saturday, February 25, 2012

Weekly Overseas Health IT Links - 25th February, 2012.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Study: Docs Have EHR Rights, but Also Responsibilities

An article published Feb. 13 in the Canadian Medical Association Journal outlines 10 “rights” that clinicians should expect in the performance of an electronic health records system, as well as corresponding responsibilities of the clinicians to use the EHR to improve the quality of care.
The article’s authors are Dean Sittig, PhD., a biomedical informatics professor at the University of Texas Health Science Center at Houston; and Hardeep Singh, M.D., assistant professor of medicine at the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, who have collaborated in the past on studies of improving EHR use and safety, including a call in late 2011 for establishment of a National EHR Safety Board.
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GE Healthcare, Microsoft name their new company

By Mike Miliard, Managing Editor
Created 02/13/2012
REDMOND, WA – GE Healthcare and Microsoft have announced senior executives and the name of their joint health IT venture, which was announced in December. The new company, called Caradigm, is expected to launch in the first half of this year.
The name is meant to embody paradigm shift in care delivery, said the firm's CEO-designate, Michael J. Simpson –  said he was pleased to find such an evocative moniker
"You see a name that reflects your company and your mission, and it just works out," he said. "We were very surprised it hadn't been taken before."
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New York to test ONCs Query Health standards

By Mary Mosquera
Created 2012-02-13 07:15
The Office of the National Coordinator for Health IT will test in New York its standards and services for electronic and distributed population health queries.
The Primary Care Information Project (PCIP) in the New York City Department of Health and Mental Hygiene will test the standards and a reference model for the Query Health project with the New York State Department of Public Health in a pilot to expand population health monitoring, according to Rich Elmore, ONC coordinator for the Query Health initiative. 
PCIP, which supports the adoption of health IT among primary care providers who tend to the city's underserved populations, will use the Query Health standards and reference implementation to expand its population health monitoring network to encompass citywide health information exchange organizational coverage of inpatient and outpatient encounters.
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UnitedHealth Launches Patient Info Service For Doctors

By TOM MURPHY   02/14/12 10:19 AM ET  
-- UnitedHealth Group's Optum business is launching a service that allows doctors to share information about patients over the Internet, as health care companies continue their push to improve care with better coordination.
The system, known as cloud computing, involves storing information and software applications on remote servers that are accessed through a secure Internet connection.
In health care, this means a doctor does not have to go to a particular computer for patient information or care updates. He or she can use portable devices like smart phones or tablet computers.
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Making a game out of doc sepsis training

By gshaw
Created Feb 15 2012 - 1:36pm
Sepsis is no laughing matter--but a new tool aims to at least make learning about the dangers of the deadly infection a little more pleasant for docs.
The web-based game--Septris--is modeled after the popular computer game Tetris. Developed by Stanford University Medical Center physicians, researchers and education technology experts, the game can be played on a mobile phone, a tablet or a computer.
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HIT Tool Kit Targets Rural Providers

John Commins, for HealthLeaders Media , February 15, 2012

It's no secret that, in general, rural healthcare providers lag behind their counterparts in urban and non-rural areas when it comes to the implementation of electronic medical records and other healthcare information technology.
The Office of the National Coordinator recently announced that only 9% of critical access hospitals had attested to meaningful use of EHR in 2011, compared with 16% of hospitals in non-rural settings. Frankly, neither statistic is worth bragging about. But the lagging achievement in critical-access hospitals points to some unique challenges that rural healthcare providers face.
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CSC takes record hit on NHS IT project

9 February 2012   Jon Hoeksma
Computer Sciences Corporation has made a $1.49 billion write-off against the National Programme for IT in the NHS, in what is thought to be the biggest ever write-off against a single IT project in the UK.
The US computer services company announced the write-off in its quarterly financial results yesterday.
The write-off equals CSC’s entire investment in the contract for the North, Midlands and East of England, where it has been struggling to install the Lorenzo electronic patient record system at trusts.
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Possible ICD-10 Delay Nets Widespread Physician Support

John Commins, for HealthLeaders Media , February 15, 2012

Signals that federal officials might "re-examine the pace" of next year's implementation dates for ICD-10 are bringing mostly favorable reactions from healthcare providers.
Marilyn Tavenner, acting administrator for the Centers for Medicare & Medicaid Services, told an American Medical Association conference in Washington, DC on Tuesday that the federal government was sympathetic to physicians' concerns about the Oct. 1, 2013 implementation date for the new standard of diagnostic classification.
"I'm committing today to work with you to reexamine the pace at which we implement ICD-10," Tavenner said as a room full of doctors applauded, according to a post from the Massachusetts Medical Society. "I want to work together to ensure that we implement ICD-10 in a way that (meets its) goals while recognizing your concerns."
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'Too Much Information': Are EHRs Drowning Primary Care?

Kate Johnson
February 14, 2012 — Although electronic health records (EHRs) are intended to streamline patient care and communication between healthcare professionals, they can lead to information overload, according to results a study published in a letter in the February 13 issue of Archives of Internal Medicine.
"Strategies to improve efficiency of electronic clinician-to-clinician messaging should be pursued to avoid burdening busy frontline health care providers," recommend Daniel Murphy, MD, from the Veteran's Affairs Health Services Research & Development Center for Excellence in Houston, Texas, and colleagues.
Their study was conducted in the outpatient clinics of a large, tertiary-care Department of Veterans Affairs facility in which the EHR includes an inbox system for "additional signature request" (ASR) alerts, defined as any note requiring an electronic signature.
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NIST seeks vendors' EHRs to study usability

By Mary Mosquera
Created 2012-02-15 11:26
The National Institute of Standards and Technology needs the help of vendors to supply their existing electronic health records so the agency can conduct research on the systems to develop procedures for measuring and evaluating their usability.
NIST wants to come up with performance-oriented user interface design guidelines for EHRs as a framework for assessing the usability of EHRs, according to the agency.
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Massive London PAS and EPR tender issued

15 February 2012   Rebecca Todd
A tender notice has been issued for a patient administration system and electronic patient record system for nine London trusts.
The estimated value of the tender, issued in the Official Journal of the European Union, is between £250m and £400m.
EHealth Insider believes this makes it the largest collaborative procurement for healthcare IT outside the National Programme for IT in the NHS.
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Patients like EHRs but worry about data security: survey

Posted: February 16, 2012 - 1:00 pm ET
Patients generally see electronic health-record systems as a good thing and want their physicians to use them, but a large percentage also see a dark side to EHRs when it comes to data privacy and security, according to a report from the National Partnership for Women & Families.
The 76-page report, "Making IT Meaningful: How Consumers Value and Trust Health IT," contains results of a survey conducted by Harris Interactive and overseen by veteran privacy researcher Alan Westin. Conducted online last August, the survey had responses from 1,961 adults. More than half (nearly 59%) said their physicians use electronic records.
A high percentage of patients surveyed reported having favorable opinions about EHRs.
When asked how useful EHRs could be in boosting quality in seven different care "elements," between 80% and 97% indicated an EHR would be useful, the report said.

ICD-10 inches closer to delay, ICD-11 in the wings

By Tom Sullivan, Government Health IT
Created 02/16/2012
WASHINGTON – The case for leapfrogging ICD-10 and holding out for ICD-11 just got a lot more curious. And though it’s not here yet, when ICD-11 is ready, it will be something ICD-10 cannot be: A 21st Century classification system.
Now that HHS Secretary Kathleen Sebelius has thrown her department’s hat in the ring, saying late Wednesday that HHS intends to delay ICD-10, the most pertinent question is how long will HHS push back compliance?
“My opinion is that CMS won't be able to announce three months or six months of delay for ICD-10,” says Mike Arrigo, CEO of consultancy No World Borders (pictured above). “They will need to announce a delay from Oct. 1, 2013 to at least Oct. 1, 2014 because of CMS fiscal planning calendars.”
Others in the industry are suggesting that even one year is not enough to lighten the burden on physicians, providers and payers to make the transition smoother.
“I have a gut feeling they’ll go for two years, who knows?” speculates Steve Sisko, an analyst and technology consultant focused on payers and ICD-10. “Maybe January 2015?”
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Lack of standardized EHR interface delaying interoperability

By mdhirsch
Created Feb 14 2012 - 11:34pm
The lack of a standardized application programming interface (API) for electronic health records is hampering the growth of information networks, according to a recent poll [1] conducted by health IT strategy and research firm Gantry Group, which recently surveyed health plans and EHR vendors on the topic.
Gantry found that 96 percent of health plans and 88 percent of vendors surveyed said that a standard API is needed to support data exchange among EHR systems. Without a single standard method for EHRs to use to communicate, the industry won't move forward with large-scale data exchange, despite the government's pumping of resources into HIT.
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Researchers: One-way sharing of data from EHRs to immunization registries risky for patients

By mdhirsch
Created Feb 14 2012 - 11:24pm
Requiring only communication from electronic health records to immunization registries, but not from the registries back to the providers, impedes data exchange and renders Meaningful Use requirements "incomplete," researchers from the University of Michigan concluded in a recent article [1] published in the American Journal of Preventive Medicine, reported about [2] in EHR Outlook.
The authors noted that Stage 1 of Meaningful Use requires providers to attest only that their EHR has successfully sent a test message to a state or regional immunization information system (IIS). However, since there is no requirement for a provider's EHR to receive any information in return from the IIS--something not likely to be a requirement under Stage 2 of Meaningful Use--the exchange of data falls short.
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Friday, February 17, 2012

Five Things To Watch at the HIMSS12 Conference

As the 2012 Annual HIMSS Conference & Exhibition opens on Feb. 20, attendees will find familiar and new education, exhibition and networking opportunities. This year, the conference comes to Las Vegas, a first for the Healthcare Information and Management Systems Society. The conference will be held at the Venetian Sands Expo Center from Feb. 20 through Feb. 24.
In my 12 years as president and CEO of HIMSS, I've found that attendees have a definite objective when they arrive at the conference -- whether it's identifying a new health IT or management systems solution or attending education sessions on a certain topic, or maybe both. With much to absorb in these five days, here is my checklist of what to watch in the week ahead.
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91% of small healthcare organizations suffered a data breach in the last year

By danb
Created Feb 17 2012 - 2:17pm
Nearly all small healthcare organizations and practices responding to a recent survey said they've suffered some sort of data breach in the past year, the Ponemon Institute announced this week. Overall, 91 percent of responding facilities with 250 employees or less said they had suffered at least one data breach, with 23 percent of respondents saying that their organizations experienced at least one patient medical identity theft in that time span.
What's more, three-fourths of respondents said that organizations lacked sufficient funding to prevent such breaches; 48 percent, meanwhile, said that less than 10 percent of their organization's annual budget was used on data security.
Major factors for such breaches included negligent employees and an inability to meet compliance requirements, according to the study's authors. Mobile device use and social media activity were considered to be areas of particular vulnerability.
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Medical imaging 'mega-cloud' in the works

By danb
Created Feb 17 2012 - 12:08pm
Efforts to create a medical imaging mega-cloud are in the works, according to an article [1] published this week in The Register. Researchers at Peake Healthcare Innovations (a collaborative venture between Johns Hopkins University and Harris Corp.), VMware, and Intel are teaming up on the project, which ultimately could become a nationwide central warehouse.
The Johns Hopkins hospital system essentially will serve as a testing ground for project prior to a nationwide rollout, according to The Register. A full private cloud version of PeakeSecure--Peake's medical records cloud--will be rolled out at Johns Hopkins next month, with a public version set for completion by in the next several months, according to Jim Philbin, Peake's chief technology officer. Philbin also serves as co-director of the Johns Hopkins Center for Biomedical and Imaging Informatics.
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Do Health IT Hires Need A Clinical Background?

The debate on which qualifications an IT job candidate needs to work in a hospital or medical practice rages.
By Paul Cerrato,  InformationWeek
February 16, 2012
If you've kept up with the news in recent months, you're aware of the shortage of qualified IT professionals to fill positions in hospitals and medical practices. The U.S. Bureau of Labor Statistics predicts that jobs in health informatics will jump by 18% by 2016 and expects there will be shortage of about 50,000 health IT workers over the next five years.
Few people challenge those statistics, but what's upsetting job candidates is that many health IT managers only want people with a clinical background. AdTech Ad
Essentially, the debate revolves around this issue: Is it easier to teach an IT generalist the clinical principles needed to work in a hospital or practice, or teach a clinician the general IT principles?
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How long before providers take the privacy rap?

By Joseph Conn
I'm sure many of you, like me, are in HIMSS mode right now. So, I'm going to interrupt your packing for the Las Vegas meeting of the Healthcare Information and Management Systems Society for only a minute.
A line jumped out at me from a report by the National Partnership for Women and Families released Wednesday: "Making IT Meaningful: How Consumers Value and Trust Health IT,". It summarized the responses from some 1,900 patients surveyed online by Harris Interactive and was overseen by veteran privacy researcher Alan Westin.
It found that patients are well aware that the current level of privacy and security protections in electronic record-keeping, quite frankly, stinks.
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Microsoft Insists on Staying Healthy

The tech company's joint venture with GE, which provides a suite of services for doctors and hospitals, gets a name

Say what you will about Microsoft, the company sure has some incredible resolve.
On Monday, Microsoft and General Electric revealed that Caradigm will be the name of their health-care joint venture. The new company should come to life sometime in the first half of this year, employing about 750 people in the Seattle area. Caradigm will take a stab at modernizing health care through applications that help hospitals, doctors, and patients manage health records and the information pouring in from various machines and databases. The general idea is to give health-care providers a way to see tons of information with one log-in and to start gathering huge amounts of information in a way that could illuminate insights about patients.
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HHS: Hospital EHR use more than doubles

Posted: February 17, 2012 - 4:15 pm ET
The percentage of hospitals that use electronic health-record systems more than doubled from 2009 to 2011, according to the results of a new American Hospital Association survey that HHS Secretary Kathleen Sebelius touted at an event in Kansas City, Mo.
More than one-third of hospitals (35%) had adopted EHRs as of 2011 versus 16% that had done so in 2009, according to the survey. In addition, about 2,000 hospitals and more than 41,000 physicians have received a share of $3.1 billion in incentives for their meaningful use of EHR systems, according to an HHS news release issued in conjunction with Sebelius' visit to Metropolitan Community College-Penn Valley Health Science Institute.
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12 trends for mobile health in 2012

By: Brian Dolan | Feb 14, 2012
Last week MobiHealthNews hosted its first webinar of 2012. During my presentation I shared my 12 trends for 2012. Our co-presenter, Aaron Kaufman from Kony Healthcare Solutions also shared his take on the year ahead. Check out the complimentary, hour-long webinar on demand right here.
1.) The Adoption of Smartphones and Tablets. This is by far the most obvious trend because it has been so steady for the past few years. It is still an important one to consider. By the end of 2011, Nielsen expected half of the US population to own a smartphone. At the end of 2011 62 percent of 25 to 34 year olds had smartphones. About 53 percent of 35 to 44 year olds did. The fastest growing age group for smartphone adoption in the past year was the 55 to 64 year old age group. Adoption among this group went from 17 percent to 30 percent a year later. Similarly the iPad has had the fastest adoption rate of any consumer electronics device in history. We know that now more than 80 percent of physicians in the US have smartphones. Between 30 percent and 50 percent have tablets now depending on who you ask.
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ONC gets $5M bump up in proposed 2013 budget

By Mary Mosquera
Created 2012-02-14 11:40
The Office of the National Coordinator for Health IT would receive $66 million, or $5 million more than the current year, under President Barack Obama’s proposed budget for fiscal 2013.
ONC’s budget would increase 8.2 percent to advance the progress in creating a nationwide health IT infrastructure, including further accelerating the adoption of electronic health records (EHRs) and their meaningful use by physicians.
ONC’s spending is part of the president’s request for $76.7 billion, or 0.4 percent more than 2012, for the small part of HHS spending that is discretionary in his budget released Feb. 13.
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Infonaut Signs Contract with University Health Network to Test Disease Surveillance System, Hospital Watch Live

February 14, 2012 (Toronto, ON) - Toronto-based health technology company Infonaut Inc. today announced it has signed a contract with the University Health Network to test its real-time disease surveillance system to control and stop hospital acquired infections, Hospital Watch Live.
Designed to assist hospitals in controlling and stopping the spread of infectious organisms, Hospital Watch Live has been installed on the multi-organ transplant unit, an area of the hospital where all of the patients are on therapies to prevent organ rejection, which also suppresses their immune systems.
Response from staff on the unit has been enthusiastic because they believe that the data generated by the system will help them increase hand hygiene compliance, track equipment throughout the unit, respond to infectious disease outbreaks, conduct studies on techniques to increase quality and better protect staff from exposure to infections. This work should also reduce overall costs to the hospital.
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PHRs will need more than data to flourish

By Government Health IT Staff
Created 2012-02-13 08:58
A bit slow on the uptake, perhaps, but the business model for Personal Health Records is taking off. And the venture capital seeded in 2011 – an amount ranking second only to the vast health information management category – is set to yield new products and bolster existing ones. But will they really be ready for patients?
Raj Prabhu certainly thinks so. As managing partner of Mercom Capital Group, Prabhu explains that the investment money, some $83 million across a dozen deals, is being injected into fledgling PHR companies thinking of new ways to advance digital healthcare record keeping, taking personal health records in new directions to avoid going the way of Google Health.
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Open Health Tools, HIMSS to collaborate on open source standards

By Mike Miliard, Managing Editor
Created 02/14/2012
CHICAGO – Open Health Tools, a multi-stakeholder group of open source advocates, has partnered with HIMSS to help spur the development of open source technology in healthcare.
Open Health Tools (OHT), whose chief health informatics officer is Robert M. Kolodner, MD, the former national coordinator for health IT, seeks to build a "ubiquitous ecosystem where members of the health and IT professions can collaborate to build interoperable systems." Its members include government agencies from the U.S., U.K and Canada, as well as vendors large and small.
OHT and HIMSS have agreed to collaborate on several fronts, including the use of open source technology, conferences and resources, such as whitepapers and webinars. This partnership will result in a new effort to deliver healthcare industry-specific guidance and non-proprietary solutions that aid in enabling the national vision of secure and seamless exchange of health information, officials say.
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The Future of High-Tech Health Care — and the Challenge

By STEVE LOHR
| February 13, 2012, 1:16 pm1
Demos, talks and a paper-plate dinner buffet were the fare last Friday evening at the Computer Museum in Mountain View, Calif., and the subject was the high-tech future of health care. The gathering was hosted by FutureMed, a health-care program that is part of Singularity University, a networked organization dedicated to exploring how disruptive technologies can sweep across whole industries and society.
The technologies on display were impressive, often inspiring — like the wearable-robots, or mechanical exoskeletons, made by Ekso Bionics, to enable people with spinal cord injuries to walk again; or I.B.M.’s Watson question-answering computer that is being morphed into a doctors’ smart assistant.
Dr. Daniel Kraft, executive director of the FutureMed program, pointed to a series of fast-changing technologies including biotechnology, nanotechnology, robotics, artificial intelligence and the surge in new data to mine for insights, or Big Data. “Exponential technologies are all around us,” Dr. Kraft said.
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Overcoming the documentation challenges of ICD-10

By kterry
Created Feb 11 2012 - 2:02pm
Healthcare system managers know that the hardest part of moving to ICD-10 will be training physicians to document their work in ways that facilitate appropriate coding. Physicians are not necessarily motivated to change their workflow to justify more granular codes. And, with only a year-and-a-half to go before the October 2013 deadline, healthcare organizations have to begin engaging doctors now to spur more complete documentation before the number of diagnosis codes explodes.
The reluctance of doctors to change their documentation habits is a major reason why the American Medical Association [2] recently asked Congress and the U.S. Department of Health & Human Services to stop implementation of ICD-10. While the Medical Group Management Association has not gone that far, MGMA continues to cite [3] a study showing how much ICD-10 will cost practices in terms of lost productivity.
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Tackling Healthcare Priorities with Technology

Edward Prewitt, for HealthLeaders Media , February 14, 2012

Our fourth annual Industry Survey, comprising the views of over 1,000 healthcare executives from a cross-section of organizations across the country, shows technology as a fairly low priority—sixth out of 12 concerns. Health IT, EMR, clinical technology, and other types and uses of technology are a top priority for only 29% of leaders. Move along, nothing here to see?
Yet when you examine executives' highest priorities, technology isn't far under the surface. The top priority listed in our survey is patient experience and satisfaction. While the actions of physicians and nurses most directly affect patient care, caregivers today rely on technology to get their jobs done.
Obviously, clinical technology such as informatics is important in this instance, but healthcare IT also has a big impact. Electronic health records can play an enormous role in improving patient experience. Is anything more powerful in caring for a patient than comprehensive health information delivered quickly?
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Health IT Factors Into Leapfrog's Hospitals Rankings

Leapfrog Group's 2011 list of 65 top hospitals in U.S. highlights facilities that use health IT to prevent deadly dosing mistakes.
By Marianne Kolbasuk McGee,  InformationWeek
February 10, 2012
The Leapfrog Group has named the nation's top hospitals for 2011, and the list shines a spotlight on how health IT can help improve patient care--even preventing medical errors that can lead to adverse drug reactions and deaths.
Leapfrog, a consortium of employers and public and private healthcare purchasers, bases its annual ranking on a survey of hospitals' processes, quality of care, and patient safety. Its evaluation includes "stringent IT requirements," said Leah Binder, Leapfrog CEO in an interview with InformationWeek Healthcare. AdTech Ad
Approximately 1,200 hospitals--or about one quarter of U.S. hospitals-- participated in the 2011 Leapfrog survey. Sixty-five facilities earned Leapfrog's Top Hospital designation.
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Data breaches put patients at risk for identity theft

By Robin Erb, Detroit Free Press

DETROIT – Walk into a doctor's office and chances are that some of your most private information -- from your Social Security number to the details of your last cervical exam and your family's cancer history -- is stored electronically.
Your doctor might access the information on a cell phone that could slip into the wrong hands. The staff might take it home on a laptop or a flash drive.
As Detroit-area health care providers take multimillion-dollar steps toward electronic records, they're talking about more than efficiency and better care. They're talking security, too.
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Indiana health exchange taps AT&T to scale up

By Bernie Monegain, Editor
Created 02/10/2012
INDIANAPOLIS – Billed as the nation’s largest health information exchange organization, the Indiana HIE (IHIE) is poised to scale up and to expand its business plans, which includes the launch of a new professional services organization to serve other HIEs.
The HIE counts 10 million patients, more than 19,000 physicians, more than 80 facilities among its stakeholders. IHIE is responsible for what its executives call "an ocean of information.” That means more than four billion pieces of clinical data in the repository. The exchange delivers three million health transactions daily.
IHIE works with hospitals, long-term care facilities, clinics and physician practices throughout Indiana to ensure health information is where it needs to be, when it needs to be there to help improve care coordination and patient outcomes.
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CIOs Need To Engage Docs In ICD-10 Transition

Focus group suggests that CIOs need to get clinicians enthusiastic about the new diagnostic coding system, but they don't know how to make that happen.
By Ken Terry,  InformationWeek
February 10, 2012
Healthcare systems preparing for the ICD-10 transition are still not devoting enough attention to preparing physicians for the clinical documentation that will be required when the number of diagnosis codes jumps from 14,000 to 68,000 next year. That's one of the conclusions that Heather Haugen, corporate vice president of the Breakaway Group, a health IT consulting firm, and Breakaway CEO Charles Fred reached after they conducted a CIO focus group.
"The number-one finding was the lack of attention being paid to clinical documentation," Haugen told InformationWeek Healthcare. "The CIOs understood issues related to vendor readiness, their own application readiness, and coder training. But under 5% mentioned provider readiness and clinical documentation improvement." AdTech Ad
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Don't Squander Your EHR Investment

Why spend all that money on an office-based electronic health record system and not take full advantage of its features?
By Paul Cerrato,  InformationWeek
February 10, 2012
Despite the fact that more than 50% of office-based physicians have implemented EHRs, most practices aren't making full use of many of the most useful features, according to Rosemarie Nelson, a principal with the Medical Group Management Association Health Care Consulting Group. Nelson, who was cited in a recent American Medical News report, said neglected features include patient portals, e-prescribing, and electronic appointment scheduling.
Why the hesitation? For some medical practices, it's probably about cost because some EHR vendors require additional fees to take advantage of the plug-ins. For other practices, it might be that their already overworked staffs just don't have time to learn and deploy the features or maybe they don't fully appreciate what these features can bring to a practice. AdTech Ad
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Electronic tools can help reduce radiation risks from medical imaging

By danb
Created Feb 13 2012 - 2:23pm
Electronic tools that track the details of medical imaging procedures and clinical decision support tools integrated with a computerized physician order entry system can reduce the risk of radiation, according to an article [1] in the journal CA: A Cancer Journal for Clinicians.
Specifically, electronic records of imaging procedures could help reduce unnecessary repetition in testing, the authors wrote. For example, in a retrospective review of medical records for 459 patients who underwent CT and MRI exams in Washington state, more than a quarter of the tests were deemed inappropriate. What's more, only 24 percent of those inappropriate tests led to positive follow-up care.
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Enjoy!
David.